多孔羟基磷灰石生物活性玻璃修复兔颌骨缺损

目的 探讨羟基磷灰石/生物活性玻璃复合多孔材料(HA-BG)修复兔下颌骨缺损的机理.方法 兔下颌骨贯通性骨缺损,分别以HA-BG及羟基磷灰石HA修复,分批处死动物,进行X光密度、组织学及新骨面积百分比观察.结果 4周、8周、12周修复区密度逐渐减小;组织学观察,随时间延长新骨呈渐进性成熟,新骨面积百分比逐渐增长,各期HA-BG组新骨面积百分比均高于HA组.结论 HA-BG具有良好的生物相容性、生物降解性及引导成骨活性.     

人工骨与自体骨复合移植修复牙周骨缺损的临床研究

目的:研究羟基磷灰石人工骨与自体牙槽窝骨复合移植对修复牙周骨缺损的作用.方法:用拔除患者自体智齿后6～12周内牙槽窝骨及羟基磷灰石人工骨复合移植修复牙周骨缺损.术后3个月和6个月、12个月X线检查及临床检查采集数据包括PD、BI、AI.结果:术后探诊深度于初诊相比有显著性差异;附着水平均有提高;骨充盈量测量显示骨缺损有显著性的改善.结论:羟基磷灰石人工骨与自体牙槽窝骨复合移植对修复牙周骨缺损发挥了优势互补的作用,临床应用效果较好.     

种植体周骨缺损修复的实验研究

目的（1）比较羟基磷灰石涂层种植体周骨缺损不同环境下骨修复能力。（2）胶原膜对成骨方面的影响。方法在犬股骨种植体周形成4 mm×4 mm×3 mm的骨缺损,4种方式修复（1）种植体＋骨缺损;（2）种植体＋骨缺损＋胶原膜;（3）种植体＋骨缺损＋羟基磷灰石;（4）种植体＋骨缺损＋羟基磷灰石＋胶原膜。术12周处死动物,取含种植体的骨段进行扫描电镜观察,测定骨接触率。结果种植体＋骨缺损骨接触率低,并可见纤维包裹。加膜可促进骨缺损区新骨形成。种植体＋骨缺损＋羟基磷灰石骨接触率约90%,加膜后并无明显差别。结论羟基磷灰石是一种较理想的骨替代材料,复合胶原膜联合运用修复种植体周骨缺损短期效果佳。     

HA修复髓室底穿的临床疗效观察

羟基磷灰石是牙体硬组织和骨组织的主要成分。近10年来国内外对其进行了大量的研究并应用于临床,证明羟基磷灰石人工骨(Hydroxy Apatite,HA)是一种生物相容性极好的骨代用材料。而HA致密多晶羟基磷灰石人工骨(HA)不同于普通的非致密羟基磷灰石及其骨代用材料,它具有致密不吸收、无毒、诱导新骨形成的作用。HA在口腔科的应用已有很多的报道。笔者应用HA修复乳、恒牙髓室底穿,并进行了1年的随访观察,与传统氧化锌丁香油糊剂、氢氧化钙糊剂进行对照比较。     

胶原复合羟基磷灰石在修复下颌骨缺损中的骨动力学变化

在中国实验用小型猪的下颌骨制备直径2cm的全层骨缺损,分别植入胶原复合羟基磷灰石和自体骨,处死前3周及1周进行四环素标记,术后2,8,12.24,48周处死动物。标本制备成6μm厚的不脱钙骨切片,在荧光显微镜下,进行骨动力学基本参数测定,并做统计学处理。结果显示,两组四环素内外标记带之间平均距离宽度及矿化沉积速率差异显著;而平均类骨质宽度及矿化延迟时间无显著差异。胶原复合羟基磷灰石植入后4周即出现矿化高峰,其成骨活动早于自体骨。认为此材料具有良好成骨作用,可替代自体骨修复颌骨缺损,并可免除患者二次手术供骨的痛苦,是一种经济实用,较为理想的骨缺损修复材料。     

骨碎补复合材料对牙槽骨缺损修复的实验研究

牙周病所致的牙槽骨缺损的修复一直是众多学者研究的课题。目前用于骨缺损修复的材料主要包括人工合成材料、天然衍生材料和复合材料,南京东南大学吕晓迎教授用猪骨提取的经羟基磷灰石和壳聚糖交联法获得的天然羟基磷灰石／壳聚糖复合材料,并用该复合材料进行了动物骨缺损的试验研究。骨碎补作为中医骨伤科的常用药物之一．在临床上应用己有很长的历史,且取得了较好的疗效。骨碎补具有促进骨折愈合、强骨补肾的功效。本试验用骨碎补的粉剂加入到羟基磷灰石／壳聚糖复合材料,观察这一复合材料修复骨缺损的情况。     

羟基磷灰石／骨碎补复合材料修复骨缺损的实验研究

目的：研究羟基磷灰石／骨碎补复合材料修复骨缺损的效果。方法：大白兔双侧下颌骨形成人工骨缺损,植入羟基磷灰石／骨碎补复合材料及对照材料。进行X线片、组织学、扫描电镜等方法观察,结果进行比较。结果：修复区密度,4、8、12、16周密度逐渐减小．存在显著性差异（P〈0．01）。组织学观察,随时间延长新骨呈渐进性成熟,扫描电镜观察也证实了新生骨呈渐进性成熟过程。实验组骨缺损修复程度优于各对照组材料。结论：羟基磷灰石／骨碎补复合材料有明显促进骨缺损修复的作用。     

纳米羟基磷灰石／壳聚糖-海藻酸钠复合材料的制备及性能研究

目的研究合理人工骨三元复合生物材料的制备及性能。方法采用共沉淀法制备了纳米羟基磷灰石／壳聚糖-海藻酸钠（n-HAP/CS-ALG）三元复合材料。用XRD、SEM、TEM和IR对材料性能进行表征。结果纳米羟基磷灰石／壳聚糖．海藻酸钠的比例为70／30时形成的复合材料中．n—HAP在有机相中分散均匀。并与有机相发生作用,界面结合牢固;复合材料中的n—HAP呈弱结晶状态,有较高生物活性。壳聚糖和海藻酸钠发生聚合。聚合物对材料起到增强作用。结论该复合材料可望作为骨组织替代材料。     

含重组人骨形态发生蛋白2复合材料的制备及体内外成骨实验研究

将重组人骨形态发生蛋白2(Recombinant human bone morphogenetic protein-2,rhBMP-2)负载于所制备的明胶/羟基磷灰石/卵磷脂复合材料中,评价其体内外诱导成骨的能力.利用冷冻干燥技术,制备出负载rhBMP-2的明胶/羟基磷灰石/卵磷脂复合支架材料,通过体外细胞实验,评价复...     

纳米羟基磷灰石和纳米羟基磷灰石／聚酰胺66直接盖髓术的组织学对比观察

随着科学技术的发展，生物材料在口腔领域引起了人们的广泛关注，羟基磷灰石因与生物体硬组织如骨、牙中的无机成份相似而具有良好的生物相容性，已被广泛用于植骨和盖髓研究。而纳米仿生材料的出现为盖髓剂的研究开拓了一个全新的领域。nHA—PA66作为新型纳米仿生材料的代表成为研究的热点，它已通过前期实验表明具有较好的生物安全性、生物相容性和生物活性其有机物和无机物的组成比例及力学性能与牙本质相似，本实验通过对比纳米羟基磷灰石和纳米羟基磷灰石聚酰胺66作狗牙直接盖髓术的组织学反应，为临床筛选理想的盖髓材料提供组织学依据。     

Bioresorbable and nonresorbable polymers for bone tissue engineering

In recent years, bone tissue engineering has emerged as one of the main research areas in the field of regenerative biomedicine. Frequency and relevance age-related diseases, such as healing and regeneration of bone tissues, are rising due to increasing life expectancy. Even though bone tissue has excellent self-regeneration ability, when bone defects exceed a critical size, impaired bone formation can occur and surgical intervention becomes mandatory. Bone tissue engineering represents an alternative approach to conventional bone transplants. The main aim of tissue engineering is to repair, regenerate or reconstruct damaged or degenerative tissue. This review presents an overview on the main materials, techniques and strategies in the field of bone tissue engineering. Whilst presenting some reviews recently published that deepen on each of the sections of the paper, this review article aims to present some of the most relevant advances, both in terms of new materials and strategies, currently being developed for bone repair and regeneration.     

复合人工骨修复材料功能性应用进展

摘 要文章检索了2009～2016年中国知网、万方等中文数据库和Pubmed、SCI E等外文数据库中有关人工骨和复合人工骨的文献资料,对常见的各类人工骨修复材料的特性和不足之处进行概括。在此基础上,文章简述了人工骨修复材料复合后的功能性应用及其原理,并简要介绍组织工程和3D打印技术在这方面的应用,为探寻新型的复合人工骨修复材料提供参考。     

纳米羟基磷灰石的制备及在不稳定药物递送中的应用

羟基磷灰石是天然骨组织中无机质的主要成分,具有良好的生物相容性、亲和性及生物降解性。被广泛地用于骨组织替代材料、整形和整容外科材料,是一种无毒、无致癌、无副作用的生物活性材料。近年来,基于纳米羟基磷灰石颗粒的新型药物传递载体在药学研究领域十分活跃。因此,本文就近年来纳米级羟基磷灰石材料的常用制备方法及在不稳定药物传递系统方面的应用进行总结归纳。     

金属材料修复临界性骨缺损的实验研究进展

金属支架材料是近年来新兴的骨组织工程支架材料之一,包括可降解金属支架材料和不可降解金属支架材料。金属支架材料生物相容性良好,耐腐蚀性强,力学性能优,相比传统支架材料,其机械强度更高,可为新组织生长提供良好的支撑,适用于临界性骨缺损(CSD)的修复,虽处于实验研究阶段,临床应用较少且时间较短,还有待进一步研究,但不可否认其在修复CSD方面具有巨大的优势和潜力,未来可能成为骨科治疗CSD的植入材料。笔者对目前常用的金属支架材料的种类及特性进行简要综述。     

Controlled Ion Release from Novel Polyester/Ceramic Composites Enhances Osteoinductivity

Due to the growing number of patients suffering from musculoskeletal defects and the limited supply of and sub-optimal outcomes associated with biological graft materials, novel biomaterials must be created that can function as graft substitutes. For bone regeneration, composite materials that mimic the organic and inorganic phases of natural bone can provide cues which expedite and enhance endogenous repair. Specifically, recent research has shown that calcium and phosphate ions are inherently osteoinductive, so controllably delivering their release holds significant promise for this field. In this study, unique aliphatic polyesters were synthesized and complexed with a rapidly decomposing ceramic (monobasic calcium phosphate, MCP) yielding novel polymer/ceramic composite biomaterials. It was discovered that the fast dissolution and rapid burst release of ions from MCP could be modulated depending on polymer length and chemistry. Also, controlled ion release was found to moderate solution pH associated with polyester degradation. When composite biomaterials were incubated with mesenchymal stems cells (MSCs) they were found to better facilitate osteogenic differentiation than the individual components as evidenced by increased alkaline phosphate expression and more rapid mineralization. These results indicate that controlling calcium and phosphate ion release via a polyester matrix is a promising approach for bone regenerative engineering.     

珊瑚羟基磷灰石结合血管内皮细胞生长因子修复兔骨缺损的实验研究

目的探讨珊瑚羟基磷灰石(CHA)结合血管内皮细胞生长因子(VEGF)修复骨缺损的效果,为其临床、科研应用提供实验依据。方法以CHA作为VEGF的可吸附性载体,制备成复合人工骨,将其植入兔尺骨中段10mm骨缺损处,以单纯CHA组,自体骨移植组和空白组作为对照,在术后2、4、8、12周,进行大体解剖、X线摄片、病理组织切片、生物力学测试等方法观察,研究各组骨愈合,血管化情况及力学强度。结果在2、4、8周病理组织切片及X线摄片显示骨缺损修复程度CHA/VEGF组明显优于自体移植骨组优于单纯CHA组,而空白组骨缺损处被纤维组织及肌组织等填充。生物力学测试显示术后12周CHA/VEGF组抗扭转强度明显优于自体骨移植组。结论CHA与VEGF结合有明显促进骨缺损修复的作用,强于自体骨移植及单纯CHA移植。二者协同,可用于骨缺损修复。     

Synthetic biodegradable polymers as drug delivery systems for bone morphogenetic proteins

Bone morphogenetic proteins (BMP) induce bone formation in vivo, and clinical application in repair of bone fractures and defects is expected. However, appropriate systems to deliver BMP for clinical use need to be developed. We synthesized a new synthetic biodegradable polymer, poly-D,L-lactic acid-para-dioxanone-polyethylene glycol block copolymer (PLA-DX-PEG), to serve as a biocompatible, biodegradable polymer for recombinant human (rh) BMP-2 delivery systems. In animal experiments, new bone was efficiently formed and a large bone defect was repaired using PLA-DX-PEG/rhBMP-2 composites. In addition, this new polymer could be used as an injectable delivery system for rhBMP-2. The rhBMP-2/PLA-DX-PEG composites also could be combined with other materials such as hydroxyapatite or titanium. This new synthetic polymer might be used for rhBMP-2 delivery in various clinical situations involving repair of bone, leading to great changes in orthopedic treatment.     

可注射性生物复合材料修复老年膝关节软骨损伤的应用分析

目的探讨可注射性生物复合材料修复老年膝关节软骨损伤的应用。方法采用前瞻性研究方法,选择2015年1月至2016年2月在我院诊治的老年膝关节软骨损伤24例,根据信封随机抽取法分为观察组与对照组,每组12例,两组都给予关节镜下手术治疗,对照组注射骨水泥进行修复,观察组使用纳米晶磷酸钙/胶原基骨材料进行修复,观察手术前后疼痛与膝关节功能情况。结果术后3个月,观察组和对照组的疗效优良率分别为91.7%与66.7%,观察组明显高于对照组(P<0.05);观察组和对照组疼痛评分分别为(2.11±1.54)、(3.61±1.44)分,明显低于术前的(4.94±2.61)、(4.84±2.53)分(P<0.05),且观察组的术后评分明显低于对照组(P<0.05);观察组与对照组术后Lysholm膝关节功能评分均明显高于术前(P<0.05),且观察组的术后评分明显高于对照组(P<0.05)。观察组与对照组术后3个月的血栓栓塞、肺部感染、下肢肿胀等并发症发生率分别为16.7%、58.3%,观察组明显低于对照组(P<0.05)。结论可注射性生物复合材料-纳米晶磷酸钙/胶原基骨材料修复老年膝关节软骨损伤具有很好的疗效,能减少并发症的发生,其作用机制可能与有效缓解及改善膝关节功能有关。     

Application of elemental microanalysis for estimation of osteoinduction and osteoconduction of hydroxyapatite bone implants

Hydroxyapatite (HAp) ceramics based on calcium phosphates, chemical compounds being natural constructive element of bones is now regarded to be one of better implantation materials in osseous surgery and stomatology. HAp is poorly soluble and slowly resorbing in tissues material. Easiness of connecting of hydroxyapatite ceramics with other materials creates possibilities to produce new composites of chemical compounds containing calcium and easier resorbing. An important and till now not fully known problem is influence of hydrodroxyapatite grafts on the processes leading to production of calcium and phosphorus ions responsive for mineralization of bone tissue around the graft. Proliferation of osteoblasts and rate of osseous trabeculas production depends, among others, concentration of calcium and phosphorus ions. The main target of this study was the comparative analysis of the bone mineralisation rate after implantation of hydroxyapatite (HAp) and composites hydroxyapatite + beta tricalcium phosphate (HAp + TCP) and hydroxyapatite + calcium hydrosulfate (HAp + gypsum), on the basis of elemental microanalysis. Implantation studies were carried out on 24 rabbits. Sections were carried out 5, 9, 11 and 14 weeks after implantation of the tested materials. The carried out punctual analysis of the occurring elements and their topographic location (mapping) in bones after implantation showed essential differences among the tested grafts. Those differences were most significant after 5 and 14 weeks and depended on the rate of the tested materials resorption. On the basis of conducted macroscopic evaluation and scanning microscope assessment we can stated that the composite of HAp+TCP showed the best osteocunductive properties, while the best osteoinductive influence was shown by the composite HAp + gypsum.     

In vivo drug release and antibacterial properties of vancomycin loaded hydroxyapatite/chitosan composite

The present study was designed to investigate the in vivo drug release and antibacterial properties of a novel mesoporous hydroxyapatite/chitosan (mesoHA-CS) composite loaded with vancomycin (VCM). VCM-mesoHA/CS composite was prepared via a freeze-drying method. The successful loading of VCM in the composite scaffold was verified by FT IR analyses. SEM observation revealed the mesoporous structure of the VCM-mesoHA/CS composite with the pore size of 50–100 µm. Medicated composites were then implanted into the muscular pockets of extremity in rabbits. The results demonstrated that local VCM concentration in muscle tissue could maintain higher than the minimum inhibitory concentration at the site of implantation for long time (i.e. 4 weeks). As a result, the number of viable methicillin-resistant Staphylococcus aureus (MRSA) on mesoHA/CS could be significantly suppressed after the VCM-mesoHA/CS implantation. These results indicated that the mesoHA/CS composite may be promising scaffold as drug storage and release vehicle applied for local antibacterial drug release and bone repair.